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The single-dose kinetics of capreomycin are described for 12 renal patients and seven healthy control subjects. Creatinine clearances (CrCl) ranged from zero to 121 ml/min. After single-dose intravenous infusions, mean +/- SD capreomycin clearance values (L/kg/h x 10(-2)) were 0.558 +/- 0.160 for the dialysis group (n = 4, CrCl = 1.4 +/- 1.9), 1.77 +/- 0.45 for the moderate renal group (n = 3, CrCl = 25 +/- 5), 2.82 +/- 1.52 for the mild renal group (n = 4, CrCl = 46 +/- 5), and 5.73 +/- 1.54 for the normal renal group (n = 7, CrCl = 109 +/- 11); p less than 0.01, using analysis of variance. The correlation between capreomycin clearance and CrCl was r = 0.90. Hemodialysis cleared clinically significant amounts of capreomycin. These data imply that capreomycin maintenance doses need to be reduced for renal patients.